PORTLAND, Maine—U.S. healthcare, chronically afflicted with inequalities, has taken an acute turn for the worse. A proposal has emerged out of the U.S. government’s budget reconciliation process to reduce funding for healthcare and other national programs by $880 billion over the course of ten years.
Alleging fraud, proponents want to clear the way for “$4.5 trillion in tax cuts through 2034.” Mostly, the very wealthy would be the beneficiaries.
Medicaid, the federal-state health insurance program established in 1965 to guarantee healthcare for low-income and/or disabled Americans, would take a big hit.
In Portland, Maine, on March 20, unionized nurses at Maine Medical Center, a big regional hub for sophisticated specialty care, staged a rally in defense of Medicaid outside U.S. Sen. Susan Collins’s office. Their union, the Maine State Nurses Association/National Nurses Organizing Committee (MSNA/NNOC), took the lead in organizing the event.
Emergency room nurse Kirsten Lane told the several dozen supporters on hand, “People with chronic illnesses would not be getting the preventative care they need … We would see a lot of people showing up to the hospital sicker. We would see a lot of hospital crowding. We would see long wait times in the emergency room.”
Intensive care nurse Julianna Hansen remarked “The patients we see every day are some of the most vulnerable people in our state … “Our seniors, those with disabilities, and our young people are the ones who would most be hurt by cuts to MaineCare and CubCare … Union nurses stand against any cuts to our patients’ access to Medicaid.”
Medicaid in Maine is known as MaineCare; CubCare refers to children’s services provided under MaineCare.
Some supporters of the nurses also spoke, including Dr. Julie Pease, longtime president of Maine AllCare, the Maine affiliate of Physicians for a National Health Program. The nurses then led the crowd in a march to Sen. Collins’ office. They requested the senator’s surprised and grumpy staff to deliver their four-foot-long fake check to her.
According to pre-rally publicity, the check was “made out to the ‘Billionaire Class’ paid for by ‘Working People’ totaling $4,182,453,166 – the amount of Medicaid funding in Maine at risk if Collins votes to gut Medicaid to fund tax cuts for billionaires.”
The MaineCare program provides coverage for almost 400,000 Maine people ─ 25% of the population ─ including two-thirds of Maine’s nursing home residents and half of Maine’s children. Nationally, 20% of all Americans and 40% of children receive healthcare through Medicaid. Medicaid covers 42% of all births in the nation and almost 50% in Maine.
Maine has a Medicaid crisis of its own. The state government in early March was facing a $118 million shortfall in payments to providers for care covered under MaineCare. Many payments would be late in arriving. Spending on MaineCare consumed 32% of the state’s budget in 2023.
A supplemental budget aimed at meeting the shortfall did not survive Republican opposition in the legislature; a two-thirds majority was required. The legislature then approved a two-year budget that provides for a one-year extension of MaineCare funding.
Apprehension exists that, if Medicaid funding is reduced, states will have to reduce expanded Medicaid services that were authorized under the Affordable Care Act, approved in 2014. Maine would have to remove 25,000 people enrolled in MaineCare, or else find $117 million more to replace lost federal funding.
According to the National Rural Health Association in February ─ Maine is a rural state ─ “Medicaid funding is critical for sustaining rural healthcare systems, including hospitals, clinics, and community health centers.”
The financial balances of almost half of rural hospitals are in the red. The diminished flow of Medicaid funding threatens those hospitals’ existence. Their demise would lead to both preventable deaths in rural areas and significant job loss. All sorts of social and healthcare services of a preventative nature would disappear.
According to the KFF health policy news service, Medicaid in 2023 covered 80% of children in poverty (and almost half of poverty-stricken adults). Medicaid also covers “nearly half of children with special health care needs.” Analyst Bruce Lesley reports that “For millions of children with disabilities and chronic illnesses, Medicaid is the difference between survival and suffering.”
Studies of infant mortality in those states that chose expanded access to Medicaid under the Affordable Care Act show significantly reduced deaths of Black and Hispanic infants. Mortality rates for them have been notoriously high in the United States for years.
Pressure on Sen. Collins from the nurses’ union, MSNA/NNOC, reflects a wide vision. Indeed, the mission statement of National Nurses United starts out this way: “Through energetic advocacy, we are organizing to: Win health care justice; accessible, quality health care for all, as a human right.”
Under the heading of sober reporting (we insist): The rally in Portland, Maine, carried out by the unionized nurses represented something far beyond good news. Our collective prospects for the short and long terms took a sharp, upward turn.
CONTRIBUTOR
